Comorbidity on axis I and treatment outcome
background Clinical practice shows that patients with complicated psychopathology are more difficult to treat than those with simple psychopathology. Comorbidity may be the complicating factor involved here. The prognostic value that comorbidity on axis I has on treatment outcome may be relevant for establishing the treatment plan for a patient and may also be relevant for the evaluation of aggregated treatment outcomes achieved by clinicians, treatment teams or institutes.
aim To investigate whether comorbidity on axis I can explain disappointing results and whether we should correct for comorbidity when comparing the aggregated treatment results achieved by clinicians, treatment teams or institutes.
method Our observational study involved a large group of patients (n = 25,651). Outcome data for a subgroup of patients (n = 7754) were available. Comorbidity in this subgroup was established by means of a structured diagnostic interview (mini-Plus) performed by trained research nurses.
results Comorbidity appeared to have some association with the treatment outcome, but the severity of symptoms seemed to be a much more powerful predictor of treatment outcome.
conclusion After correcting for baseline severity, we found that comorbidity had very little prognostic value as far as the treatment outcome was concerned.